Treatment-associated changes in malocclusion and oral health-related quality of life: A 4-year cohort study.

INTRODUCTION: The impact of orthodontic treatment on oral health-related quality of life (OHRQoL) in adolescents being treated in orthodontic practices has not yet been explored longitudinally. The aim of this cohort study was to describe the changes in both malocclusion and OHRQoL with orthodontic treatment. METHODS: One hundred seventy-four patients (ages, 10-17 years; 64.4% girls; 81.6% European) underwent 2-arch, fixed-appliance treatment in a 4-year prospective study conducted across 19 specialist orthodontic practices throughout New Zealand. They were assessed before treatment, at debond (when 87.4% of the baseline sample were reassessed), and at a mean 21 months postdebond (when 59.4% of the baseline sample were reassessed). OHRQoL was measured using the Child Perceptions Questionnaire, and the Dental Aesthetic Index was used to measure occlusion. RESULTS: Among the 104 patients who took part in all 3 assessments, little change in OHRQoL overall was seen at the end of treatment, despite considerable improvement in malocclusion (with the mean Dental Aesthetic Index score falling from 35.9 at baseline to 21.3 at debond). The mean Child Perceptions Questionnaire 11-14 was slightly greater at debond, and this was most notable in the functional limitations subscale. By the end of the study (21 months postdebond, on average), the decreases in Child Perceptions Questionnaire 11-14 scores were all substantial, especially in the emotional well-being and social well-being subscales. CONCLUSIONS: Malocclusion affects orthodontic patients' OHRQoL before treatment. A temporary increase in symptomatic impacts seen by the debond stage appears to ameliorate with time, with the benefits of orthodontic treatment for OHRQoL manifesting themselves some months later.

The socio-demographic and malocclusion characteristics of adolescents presenting for specialist orthodontic treatment in New Zealand practices.

BACKGROUND: There are few reports of the socio-demographic and malocclusion characteristics of those undergoing clinical orthodontic treatment in private specialist practice. AIM: To describe the pretreatment characteristics of individuals presenting for orthodontic treatment. METHODS: Individuals (N = 174) presenting for orthodontic treatment in 19 private specialist orthodontic practices in New Zealand were randomly selected and examined (at the beginning of a three-year prospective study) and their malocclusions compared using the Dental Aesthetic Index (DAI). RESULTS: The mean DAI score was 35.8 (SD 8.4). There were no statistically significant socio-demographic differences in DAI score other than by household-based socio-economic status (SES), whereby mean scores were considerably higher in those of low SES. The majority of patients attending for treatment had severe or very severe/handicapping malocclusions. Females had less severe malocclusions than males, on average, although the difference was not statistically significant. CONCLUSIONS: The malocclusion severity threshold for seeking orthodontic treatment appears to be higher in those of lower SES. The study findings highlight the need to improve access to orthodontic treatment for this group.

Quality of life and orthodontics: a challenge to traditional concepts. Report of the 2009 NZAO Symposium.

The biennial symposium of the Education, Research and Development Group (ERDG) of the New Zealand Association of Orthodontists (NZAO) was held in Wellington on 2 and 3 October 2009. The challenging topic was the application of Quality of Life research to the practice of orthodontics. The well-established format of pre-symposium reading by participants, symposium lectures and discussion groups leading to consensus once again proved an excellent basis upon which to engage this subject. The findings reported here represent the consensus reached by delegates attending the symposium.